Prognostic factors for patients with advanced seminoma treated with platinum-based chemotherapy.
Kaye, Stan B
AffiliationNorwegian Radium Hospital, Department of Medical Oncology, Montebello, Oslo, Norway.
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AbstractPrognostic factors for 3-year progression-free survival (PFS) were defined in 286 patients with advanced seminoma treated with cisplatin-based chemotherapy at 10 European oncology units (no prior treatment: 236; prior radiotherapy: 50). Previously irradiated patients displayed a 69% PFS as compared to 87% in those presenting with advanced seminoma at the time of diagnosis (P = 0.009). In the univariate analysis, the extent and site of disease before chemotherapy and the level of serum LDH (< 2.0 versus > or = 2.0 x upper limit of normal) correlated with PFS in previously non-irradiated patients, but not in patients with prior radiotherapy. The multivariate analysis was, therefore, restricted to previously non-irradiated patients. The presence of non-pulmonary visceral metastases and a serum LDH level of > or = 2 x normal (N) proved to be independent prognostic factors. Based on these variables, two prognostic models were constructed and validated in an external data set of 166 comparable patients. For clinical use, Model 2 is recommended. The good-prognosis group comprises non-irradiated patients with stage II seminoma and any LDH level at presentation, or stage III and IV patients (with lung metastases only) whose serum LDH level is < 2 x N. These patients display a 94% 3-year PFS. The poor prognosis group includes all other patients with a 56% PFS. With this prognostic model, individualisation of the therapeutic approach may be considered in patients with advanced seminoma and a high risk of chemotherapy-related toxicity.
CitationPrognostic factors for patients with advanced seminoma treated with platinum-based chemotherapy. 1997, 33 (9):1380-7 Eur J Cancer
JournalEuropean Journal of Cancer
- Advanced seminoma--treatment results and prognostic factors for survival after first-line, cisplatin-based chemotherapy and for patients with recurrent disease: a single-institution experience in 145 patients.
- Authors: Gholam D, Fizazi K, Terrier-Lacombe MJ, Jan P, Culine S, Theodore C
- Issue date: 2003 Aug 15
- [Management of advanced seminoma: retrospective study of 96 patients].
- Authors: Bompas E, Fléchon A, Biron P, Droz JP
- Issue date: 2002 Oct
- Serum lactate dehydrogenase and human choriogonadotrophin in seminoma.
- Authors: Fosså A, Fosså SD
- Issue date: 1989 Apr
- Radiotherapy after chemotherapy for metastatic seminoma--a diminishing role. MRC Testicular Tumour Working Party.
- Authors: Duchesne GM, Stenning SP, Aass N, Mead GM, Fosså SD, Oliver RT, Horwich A, Read G, Roberts IT, Rustin G, Cullen MH, Kaye SB, Harland SJ, Cook PA
- Issue date: 1997 May
- Serum lactate dehydrogenase level is a prognostic factor in patients with locoregionally advanced nasopharyngeal carcinoma treated with chemoradiotherapy.
- Authors: Turen S, Ozyar E, Altundag K, Gullu I, Atahan IL
- Issue date: 2007 Aug